Here is one who disagrees. The case for reconfiguration and switching resources from acute to community care is not as straightforward as she argues. First, there is not an unequivocal case for economies of scale or for quality improvements from scale – see Monitor's reports or the work of the King's Fund's Anthony Harrison. The empirical evidence for investment in out-of-hospital care as a means of reducing demand for acute care is also unconvincing – as a recent Bristol University study demonstrated .

Toynbee must stop listening to the big management consultancies and thinktanks that stand to make money from "change" and clinicians with vested interests in ensuring in a time of straitened finances they keep their funds – yes, the teaching hospitals yet again.

Aneurin Bevan never really believed that spending on preventive medicine would save money; it was a story to justify the surge in NHS spending as soon as access to healthcare became available and keep the Treasury at bay. But the Treasury has learnt its lesson and is seeking to reduce healthcare capacity and access.

How else to explain cuts in junior doctors; reductions in beds; closures of accident and emergency departments; and the promotion of the role of the GPs in restricting access through gatekeeping and rationing?Seán BoyleSenior research fellow, LSE